NPIMap

Organization Active NPI

Metropolitan Neurosurgery, PA

  • Neurological Surgery Physician
  • Coon Rapids, MN
National Provider Identifier
1386690543
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
METROPOLITAN NEUROSURGERY, PA
Practice address
11850 Blackfoot St NW
Ste 490
Coon Rapids, MN 55433-2578
Phone
(763) 427-1137
Fax
(763) 427-4643
NPI assigned
May 26, 2006
Last updated
Apr 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kyle S NelsonNPI 1194987289
Title
President
Phone
(763) 427-1137

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X NU
Acute Care Nurse Practitioner 363LA2100X NU
Neurological Surgery Physician 207T00000X NU Primary

Addresses

Primary practice location

11850 Blackfoot St NW
Ste 490
Coon Rapids, MN 55433-2578

Mailing address

11850 Blackfoot St NW
Ste 490
Coon Rapids, MN 55433-2578
Phone (763) 427-1137

Other identifiers 1

IdentifierTypeStateIssuer
591713100MedicaidMN

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

7235 Ohms Ln
Minneapolis, MN 55439
Phone (952) 204-3502

800 E 28th St
#304
Minneapolis, MN 55407

3300 Oakdale Ave N
Ste 110
Robbinsdale, MN 55422

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1386690543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11850 BLACKFOOT ST NW",
            "address_2": "STE 490",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332578",
            "telephone_number": "763-427-1137",
            "fax_number": "763-427-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11850 BLACKFOOT ST NW",
            "address_2": "STE 490",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332578",
            "telephone_number": "763-427-1137",
            "fax_number": "763-427-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN NEUROSURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-11",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-427-1137"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "591713100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.